Refractive Surgery After Radial Keratotomy (RK)
Serving Orange County, California and Surrounding Communities
Radial Keratototmy (RK) was a procedure for treating nearsightedness. It worked by flattening the corneal curvature, which is too steep in myopia patients. Perhaps you had RK when there was no other option. It probably worked for many years and then gradually, over time, reading became a problem. Now perhaps you are even wearing distance glasses, or astigmatism is bothering you. The wonderful surgeon who improved your vision is now retired. So what do you do now?
Dr. Khanna has helped many patients improve their sight after Radial Keratotomy (RK).
Why RK Was Discontinued in the U.S.
RK involved making vertical incisions in the cornea, penetrating up to 95% percent of your corneal depth. The number of incisions ranged from two to eight depending on your vision prescription. Some surgeons were more aggressive and made 16 or even up to 64 cuts on the cornea.
We now know that these incisions weaken your cornea. The eyes are filled with fluid that exerts outward pressure, and a weakened cornea may not be able to keep its curvature against that pressure. This leads to fluctuations in vision between morning and night. Residual astigmatism may also be contributing to glare at night.
The PERK Study
The U.S. National Eye Institute did a ten-year study called the Prospective Evaluation of Radial Keratotomy (PERK) to evaluate the short-term and long-term effectiveness of one of the RK techniques. Researchers concluded that although RK did improve myopia, its effectiveness varied from patient to patient.
It also demonstrated that there was an annual drift towards corneal flattening, which caused the eye to become gradually more farsighted. The results of this study showed that a post-RK eye was permanently unstable, and this led to RK falling out of favor in the U.S.
Challenges in Operating on Post-RK Eyes
- The cornea is very flat
- There is astigmatism or irregular astigmatism
- The posterior curvature is different
- The optical zone is small (the area where surgical changes can be made)
- Ophthalmic diagnostic instruments may not be able to display accurate readings of the cornea
- IOL (Intraocular Lens, such as ReSTOR® or Crystalens®) power calculations may also require modifications because of each post-RK cornea being different
Restorative Surgical Methods after RK
Despite the challenges listed above, there are various techniques that can be used to improve vision after Radial Keratotomy. An experienced corneal surgeon like Dr. Khanna can analyze the exact problem and devise a tailor-made treatment plan. Since Dr. Khanna is trained and certified in multiple technologies, he can combine them to improve your unique vision.
Dr. Khanna can use Wavefront LASIK to enlarge the optic zone and eliminate astigmatism or hyperopia. He can then use Intacs to strengthen the corneal cross linkage, which increases the cornea’s rigidity.
Rajesh Khanna, M.D., is also skilled in Refractive Lens Exchange surgery. If you have cataracts, special calculations and highly skilled surgery would be required. If you want to see far and near in each eye, than PRELEX may be an option (Presbyopic Lens Exchange).
To find out which procedure is right for you, contact The Khanna Institute today to schedule a free vision consultation. Our friendly staff can answer any questions you may have about Dr. Khanna’s approach to correcting Radial Keratotomy (RK) problems.
We serve patients throughout the Los Angeles area, with offices in Beverly Hills and Westlake Village, California.